Ventricular septal fistula formation due to infectious endocarditis in a hemodialysis patient with aortic valve replacement

We report a case of infectious endocarditis in a 77-year-old woman who was undergoing maintenance hemodialysis therapy, and who was also having a prosthetic aortic valve replacement. The disease resulted from a local skin infection at the needle puncture site of the arteriovenous fistula. Ampicillin-resistant Staphylococcus aureus was the causal organism. Surgical treatment could not be performed because of associated intracranial hemorrhage due to septic embolism. In spite of intensive treatment with several antibiotics, a ventricular septal abscess just beneath the prosthetic aortic valve progressed to form a ventricular septal fistula. The resultant intracardiac left-to-right shunt led to refractory congestive heart failure. The patient finally died of heart failure. The formation of a ventricular septal fistula is considered to be a rare and extraordinary complication of infectious endocarditis in a hemodialysis patient with aortic valve replacement. Received: July 25, 2001 / Accepted: November 3, 2001     

妇女叶酸增补中需要关注的问题

妇女围孕期增补叶酸能够有效预防神经管缺陷等疾病的发生。随着对叶酸研究的不断深入，叶酸补充中出现了诸多问题。本文简要综述了叶酸在服用方式以及基础和临床研究中出现的值得讨论、已经引起关注和需要进一步研究探讨的问题，并提出了深入研究叶酸可能的发展趋势。     

心血管疾病并发焦虑抑郁症状2050例心理干预治疗分析

目的:了解心血管疾病并发焦虑抑郁症状的情况并探讨心理干预等对焦虑抑郁症状的影响。方法:对住院的2050例心血管疾病并发焦虑抑郁症状的患者进行回顾性分析。结果:心血管疾病患者中并发有焦虑抑郁症状者占56%;其常表现为类似心绞痛、左心衰竭症状,可并发有心律失常;高血压病并发有焦虑抑郁患者对血压升高的耐受性差,动态血压检查以非勺型改变者居多;单纯使用心血管药物治疗效果欠佳,心理干预,焦虑抑郁症状严重者结合抗焦虑抑郁药物疗效显著。结论:心血管疾病患者常并发焦虑抑郁症状,心理干预治疗等可有效改善患者的症状。     

玉溪市2004年女职工普查结果分析

目的：为了解女职工患妇女病现状，充分认识普查普治必要性。方法：对玉溪市部分女职工进行常规妇科检查、白带多项快染、宫颈荧光筛查、乳腺红外线扫描。结果：女职工患病率74．54％，阴道炎患病率18．67％，宫颈糜烂患病率21，04％，子宫肌瘤占受检人数10．79％，慢性输卵管炎占9．60％，卵巢囊肿占4．3％，乳腺小叶增生患病率为26．86％，乳腺纤维瘤占0．43％，IF荧光宫颈癌筛查3-4分占8．33％。结论：女职工患病率高，提高宣传力度，定期开展妇女病普查普治尤为必要。     

Primary aspergillosis of the sphenoid sinus with pituitary invasion – a rare differential diagnosis of sellar lesions

Summary Aspergillosis belongs to the group of mycotic diseases of paranasal sinuses. The invasive forms, and particularly the fulminant forms, are potentially fatal. Isolated aspergillosis of the sphenoid sinus or the clivus is a difficult diagnosis, since the often misleading clinical manifestations of this rare disease develop late. These patients become apparent by neurological signs such as cavernous sinus syndrome, pseudotumor of the pituitary or the orbit. Diagnosis is often made intra-operatively or on histological examination. We report a case of invasive aspergillosis uniquely involving the sellar area revealed by clinical features suggesting a pseudotumor of the pituitary. Although such lesions are almost always seen in immune suppressed subjects, in our case, the patient was immune competent and had no past history of sinusitis. The question of whether, and when to perform limited or extensive surgery remains an issue for discussion, owing to the rarity of this disease honed by lack of experience. It depends on several factors: the kind of disease, the immunity, the subtype of invasive fungal sinusitis and the degree of tissue invasion.     

急性脑血管病病人应激状态的临床特点及护理

[目的 ]分析急性脑血管病(ACVD)应激状态的临床特点 ,探讨防治策略及护理对策。 [方法 ]回顾分析 3 62例ACVD病人的临床资料。[结果 ]ACVD病人应激反应的发生率为 47.5 1% ,病死率为 11.88%。 [结论 ]早期明确诊断与治疗 ,并采取措施积极调控机体应激状态 ,加强护理 ,有助于控制病情和促进康复 ,降低病死率。     

不同采血针对新生儿足跟采血成功率的影响

目的：探讨不同采血针在新生儿疾病筛查采血中的采血效果。方法：采用三种采血针分别对2126例（A组）、1786例（B组）、1471例（C组）新生儿进行足跟采血，比较其采血成功率。结果：A、B、C三组之间差异有统计学意义（P〈0．01）。结论：采用7号一次性注射针头采血（C组）可明显提高采血成功率。     

超声引导下VacoraTM旋切系统的实验研究

目的探讨VacoraTM真空辅助活检系统的准确性和安全性,为临床应用奠定基础。方法选用里脊肉和鱼丸作为实验材料,根据鱼丸大小将实验分为5组:0.5、0.8、1.0、1.5及2.0cm组,每组鱼丸3~5个。采用VacoraTM活检系统,先行灰阶超声扫查肌肉后将鱼丸置入肌肉中,超声扫查置入的鱼丸,同轴套管针在超声引导下插入鱼丸底部,在套管针引导和超声监视下行旋切真空抽吸术;旋切后取出采样腔内的组织标本,用超声检查肌肉内的残腔,确定无鱼丸残留声像图。结果每次旋切组织条比较完整,其大小为20.0mm×0.6mm,旋切次数随鱼丸大小的增加而增加;0.5、0.8、1.0、1.5及2.0cm组里脊肉内鱼丸全部切除的平均旋切次数分别为12、15、19、26和31。所用的平均时间分别为15、18、23、27和34min。结论VacoraTM真空辅助活检系统定位准确、取样完整、操作简便。可为良恶性病变的诊断提供足够量的病理检查标本,为良性病变的完全切除提供具有潜在价值的手段。     

小儿输尿管开口异位的诊断和治疗(附22例报告)

目的 提高小儿输尿管开口异位的诊治效果。方法 总结22例输尿管开口异位患儿临床资料。男1例，女21例。年龄1个月～12岁，平均4岁。单侧17例，双侧5例。21例女童中，有正常分次排尿伴异常漏尿18例，完全持续性漏尿3例；1例男童有上尿路梗阻及泌尿系感染。异位开口于阴道14例、尿道4例、前庭3例、膀胱颈1例。结果 手术治疗20例，其中肾切除者11例、半肾切除者7例，术后漏尿症状消失，3例合并输尿管残端综合征；1例双输尿管膀胱再植术后仍有尿失禁；1例直肠化膀胱术无漏尿症状。结论 明确诊断，选择合理手术是小儿异位输尿管口治疗成功的关键。     

MMP-9及TIMP-1在大鼠感染性脑水肿的表达及意义

目的探讨MMP-9及TIMP-1在大鼠感染性脑水肿的表达及意义。方法应用免疫组织化学方法（SP法）检测大鼠急性感染性脑水肿模型中MMP-9及TIMP-1的表达情况及其比值变化。结果MMP-9及TIMP-1在LPS组各时间点表达均高于对照纽且各时间点MMP-9／TIMP-1比值均明显升高（P〈0．05）。结论MMP-9及TIMP-1可能参与了感染性脑水肿的发生和发展。